FQHC Billing Services

Expert Medical Billing and Revenue Cycle Management Tailored to Federally Qualified Health Centers

Why Outsource FQHC Billing to HBH Solutions?

 Federally Qualified Health Centers (FQHCs) provide diverse medical services and employ a wide range of healthcare professionals, making billing for these facilities uniquely complex. Adhering to the specialized billing and coding requirements set by the Centers for Medicare & Medicaid Services (CMS) is crucial for FQHCs. This is where outsourcing to experts like HBH Solutions can make a significant difference. We specialize in FQHC billing and revenue cycle management (RCM), ensuring compliance with all CMS rules while optimizing your revenue.

Our streamlined billing system has been refined over a decade, designed to reduce claim errors and maximize revenue. We carefully review claims for accuracy before submission, follow payer guidelines, and track each claim through the payment process. We also handle denied claims with no additional charge, ensuring no claim is overlooked.

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Experienced, HIPAA-Compliant Billing Experts

 Due to the wide range of services offered by FQHCs, it’s challenging for medical staff to stay up-to-date with the latest coding practices. HBH Solutions provides certified, experienced coders and billers specifically trained in FQHC billing, ensuring accuracy and compliance. Our team is also well-versed in HIPAA regulations, safeguarding patient information and maintaining your organization’s compliance.

Unique Billing Challenges for FQHCs

  • Per-Diem Billing
    FQHC billing requires handling multiple same-day visits carefully. For instance, if a patient has both a medical and a mental health visit on the same day, or if a new diagnosis is involved, separate billing is allowed. Our billers are trained to follow these nuanced rules and prevent improper claim submissions.
  • Off-Site Billing
    FQHC services can occur in various locations, such as a patient’s home or a Skilled Nursing Facility. Accurate coding for these off-site visits must reflect the medical necessity and location, and our team is fully trained to manage these variations.
  • Behavioral Health and Substance Abuse Billing
    FQHCs often offer behavioral health services alongside medical care. Our billers are familiar with CMS rules for psychiatric consultations, substance abuse treatments, and other specialized services.

Boosting Revenue and Streamlining RCM with HBH Solution

  • Cutting-Edge Software
    We use proprietary billing software to ensure up-to-date, accurate coding throughout the billing process, starting from the moment a patient books an appointment to the final payment.
  • Comprehensive RCM Services
    In addition to expert billing, we offer full RCM services, including payer credentialing, compliance reviews, coverage verification, and annual payer adjustments, allowing you to focus on patient care while we streamline your financial workflow.

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